以防风通圣散探析刘完素开玄三法

An analysis of Liu Wansu’s three methods of opening the Xuanfu from Fangfeng Tongsheng San

自《黄帝内经》“所谓玄府者,汗空也”,始提玄府,后世医家对玄府多有论述,但见解不一。其中,以刘完素对此理论论述最为详尽,并认为“然玄府者,无物不有”,扩大了玄府的范围。开阖通利为玄府的生理常态,闭密郁结是玄府的病理状态。刘完素提出阳热怫郁是玄府为病的基本病机,玄府闭密是阳热生内郁、热郁致结的复杂病理结果。刘完素认为玄府闭密需以清、宣、通同用为基本治法,并创立防风通圣散一方,以清、宣、通三法同用共开玄府之闭,即以寒凉之药行清热之功,凭辛味之药奏宣郁之效,借苦寒之药行通下之用,并以清热为主,宣郁为辅,通结为助。结合内、外、妇、儿、五官等名家医案,浅解防风通圣散清、宣、通三法同用的基本思路及其在临床各科的运用,为防风通圣散的临床运用提供借鉴和启发。

Xuanfu was first mentioned in the Huangdi Neijing.Later physicians also published many discussions of Xuanfu, but their opinions were conflicting.Among these physicians, Liu Wansu provided the most detailed discussion about this theory.He claimed that “Everything has Xuanfu,” which expanded the scope of Xuanfu.Opening and closing in order is the physiological normal state of Xuanfu, and closed stagnation is the pathological state of Xuanfu.Liu Wansu proposed that yang-heat depression is the basic pathogenesis of Xuanfu disease, and Xuanfu closure is a complex pathological result of yang-heat generating inner stagnation.Liu Wansu believed that the basic method of opening Xuanfu is to use clearing, diffusion, and purgation together, and he created Fangfeng Tongsheng San.The three methods of clearing, diffusion, and purgation are used together to open the Xuanfu, that is, using cold medicine to clear away heat, and dispelling stagnation with pungent and bitter cold medicines;clearing heat is the main method, and diffusion and purgation serve as auxiliary methods.Combined with the medical records of reputable doctors in various specializations including internal medicine, surgery, gynecology, pediatrics, and otorhinolaryngology, this paper roughly analyzes the basic concept of using Fangfeng Tongsheng San’s three method of clearing, diffusion, and purgation and discusses their applications in various clinical departments, aiming to provide a reference and inspiration for the clinical application of Fangfeng Tongsheng San.